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Organization

PEDIATRIC CONSULTANTS AT CEDAR BLUFF

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA OWENS (MANAGER)
(865) 560-8778
Entity
Organization

Contact information

Practice address
9333 PARK WEST BLVD STE 104, KNOXVILLE, TN 37923-4305
(865) 560-8778
(865) 394-6599
Mailing address
DEPT 888214, KNOXVILLE, TN 37995-8214
(865) 670-6199
(865) 670-6198

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q013042
TN
Enumeration date
03/13/2008
Last updated
11/01/2017
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